200 Section - Standardization of Platelet Concentration in Platelet-Rich Fibrin Scaffolds: A Case Report on Chronic Non-Healing Pressure Ulcers in SCI

Traumatic SCI with BBI with Grade IV pressure injury
For chronic non healing ulcer, PRF was applied weekly x3. healing rate of 3.33%, reduction of PUSH score from 13
to 9 was noted. Healthy granulation tissue appeared, ultimately resulting in reepithelialisation after 5 weeks from the 1st application of PRF.

Case Description:

Standardisation of PRF procedure: On reviewing literature there is no available direct method for standardisation. In our study, we have calculated the platelet count (pc) from all 3 layers after centrifugation and compared it with the baseline pc values. All the layers  were analysed for pc. For the purpose of PRF preparation, 20ml sample was taken out of which 10ml was collected in a sterile empty vial and centrifuged at 3200rpm for 10minutes. This resulted in the formation of the PRF scaffold which was separated aseptically and placed over ulcer. The other 10ml sample was centrifuged at the same settings, following which the supernatant liquid was separated and CBC was done revealing a platelet concentration of 6x10³/μL . The RBC remnant (layer 3) was sent for CBC which revealed a platelet concentration of 1x10³/μL.

Discussions: We can conclude that  remaining pc, on subtracting that of the supernatant and the RBC component from the baseline, is the concentration present in the scaffold. This was calculated to be 168x 10³/μL-(6000+1000)/ μL= 161x 10³/μL.
Findings were also confirmed by microscopic examination of all 3 layers.
Fibrin clot of layer 2 with entrapped platelets. Platelets marked by arrow (x400, H&E).
Peripheral smear of the Layer 3 - No platelets were noted (x1000, Leishman stain).
Smear from supernatant- Layer 1 –Only occasional RBCs and WBCs were noted (x1000, Leishman stain)

Conclusions: Above examination of PRF provided proof that the pc in
the PRF scaffold was maintained and at par with that prepared by Choukron et al.